Noticing a flat spot on your baby’s head or observing that your infant consistently tilts their head to one side can be worrying. Two common conditions parents often encounter in infancy are torticollis and plagiocephaly. While both may sound intimidating, early diagnosis and treatment can lead to a full recovery.
In this blog, we’ll help you understand:
- What infant torticollis and plagiocephaly are
- Their causes and signs
- Effective treatments and prevention strategies
What Is Infant Torticollis?
Infant torticollis, also known as congenital muscular torticollis, is a condition where a baby’s neck muscles are tight or shortened, causing their head to tilt to one side and the chin to point in the opposite direction.
Common Signs of Infant Torticollis:
- Head consistently tilted to one side
- Difficulty turning the head in both directions
- Preference for breastfeeding on one side
- Flattening on one side of the head (due to consistent head position)
- Possible presence of a small lump in the neck muscle
Did you know? Torticollis is quite common and occurs in about 3 in every 100 babies.
What Is Plagiocephaly (Flat Head Syndrome)?
Plagiocephaly refers to the flattening of one part of a baby’s skull. It often develops when a baby lies in the same position for long periods—especially on their back.
There are two types of plagiocephaly:
- Positional Plagiocephaly: Most common and results from consistent head position.
- Congenital Plagiocephaly: Caused by conditions present at birth, like craniosynostosis.
Signs of Plagiocephaly:
- Flattened area on the back or side of the head
- Asymmetry of the ears or forehead
- Head shape that looks uneven
Note: Plagiocephaly is mostly cosmetic but can be associated with torticollis.
The Link Between Torticollis and Plagiocephaly
Torticollis and plagiocephaly often go hand in hand. When a baby has torticollis and favors turning their head one way, it can lead to flat spots on the skull due to pressure on the same area.
Early intervention is key to preventing or reducing skull flattening and promoting normal head and neck movement.
What Causes Infant Torticollis and Plagiocephaly?
Causes of Infant Torticollis:
- Intrauterine position: Baby’s position in the womb can compress neck muscles.
- Birth trauma: Muscle injury during delivery, especially with forceps or vacuum.
- Muscle tightness: Tight sternocleidomastoid muscle in the neck.
Causes of Plagiocephaly:
- Sleep position: Babies spending long hours lying on their back.
- Torticollis: Causes limited movement and constant pressure on one side.
- Multiple births: Less space in the womb.
- Premature birth: Softer skull bones make flattening more likely.
Diagnosis of torticollis or plagiocephaly
If you notice signs of torticollis or plagiocephaly:
- Consult a pediatrician: They will examine your baby’s head shape and neck mobility.
- Referral to specialists: In some cases, your baby may see a physical therapist or pediatric osteopath.
- Imaging: Usually not needed but might be recommended in rare cases.
Treatment Options for Infant Torticollis and Plagiocephaly
1. Physical Therapy
- Core treatment for torticollis.
- Includes stretching exercises to loosen the tight neck muscle.
- Therapists also guide parents on repositioning strategies.
2. At-Home Exercises
- Gentle daily stretches (as prescribed by your healthcare provider).
- Encourage tummy time to build neck strength.
- Alternate head position during sleep and feeding.
3. Helmet Therapy (for Plagiocephaly)
- A custom-molded helmet may be recommended for moderate to severe cases of flat head syndrome.
- Best results occur when started between 4–6 months of age.
4. Osteopathic Treatment
- Pediatric osteopaths use hands-on techniques to improve mobility and reduce tightness.
- Shown to help relieve muscle tension and support alignment.
5. Positioning Techniques
- Switch baby’s head direction during sleep.
- Use toys or mirrors to encourage looking in different directions.
- Avoid prolonged time in car seats, swings, or carriers where the head rests in the same position.
Preventing Flat Head Syndrome and Torticollis
While not all cases are preventable, the following tips can reduce the risk:
- Daily tummy time while your baby is awake and supervised.
- Alternate feeding sides (bottle or breast).
- Use baby carriers or upright holding instead of lying flat for long periods.
- Rotate crib orientation so baby turns their head in different directions.
When to Seek Help
Contact your pediatrician if:
- Your baby’s head consistently tilts to one side
- You notice a flat spot on their head
- Your baby resists turning their head or seems uncomfortable
Early treatment typically leads to great outcomes, often with minimal intervention.
Final Thoughts
Torticollis and plagiocephaly are common and manageable with early recognition and care. Through a combination of professional guidance and at-home support, most babies show significant improvement within a few months.
If you're concerned about your baby’s head shape or neck movement, don’t hesitate to consult your pediatrician. Prompt action can ensure your baby continues to grow and thrive with ease.
Your child’s health is our priority. Contact NJ Craniofacial Center to book your appointment or learn more about our comprehensive pediatric craniofacial services.
FAQs
Q: Can a baby outgrow torticollis or plagiocephaly without treatment?
A: Mild cases may improve on their own, but professional assessment and early therapy offer the best outcomes.
Q: How soon should treatment start?
A: As early as possible—ideally before 3 months—for the most effective results.
Q: Are helmets safe for treating flat head syndrome?
A: Yes, when fitted by a trained specialist, helmets are safe and effective for moderate to severe plagiocephaly.
Q: How much tummy time should my baby get?
A: Start with a few minutes several times a day and gradually increase to about 30–60 minutes total per day.
